Editorial: Ruling that health law a tax settles one issue, raises others

Thursday

Jun 28, 2012 at 12:01 AMJun 28, 2012 at 4:57 AM

Thursday’s U.S. Supreme Court ruling upholding the federal health care law as a tax contained surprises, but it does clear up some questions and draws some important limits on federal authority.

Thursday’s U.S. Supreme Court ruling upholding the federal health care law as a tax contained surprises, but it does clear up some questions and draws some important limits on federal authority.

The court’s 5-4 decision on the Affordable Care Act (ACA) was surprising for at least two reasons.

First, it was not decided by swing Justice Anthony Kennedy — who actually sided with opponents of the law — but instead by Chief Justice John Roberts, who is labeled by critics as being too conservative. This time, he straddled a 4-4 split between four justices who wanted to strike down the law completely and four who wanted to uphold it completely.

Second, the law was found to have exceeded the Constitution’s Commerce Clause and its Necessary and Proper Clause. It was upheld, however, under Congress’ powers to tax. That particular argument had not succeeded with lower court judges, and indeed President Barack Obama himself tried to claim the law is not a tax.

By emphasizing it is a tax, though, the ruling draws some important lines on Congress’ other powers. The court’s majority ruled Congress cannot use the Commerce Clause to force people into commercial activity — such as making them purchase something. Congress and the president must seek a tax or other enumerated power to compel that.

It also clarified that the federal government cannot threaten states by taking away Medicaid funding if a state declines to join a Medicaid program expansion. Only new funding that would go to the expansion can be withheld. This is important because federal authorities have used transportation, environmental and other funding to force states to go along with programs that states opposed.

As we’ve noted before, simply because a law is constitutional does not necessarily make it a good law. Roberts himself stated that, “We do not consider whether the act embodies sound policies. That judgment is entrusted to the nation’s elected leaders.”

Indeed, the ACA’s costs to provide health insurance for an estimated 30 million out of the more than 46 million uninsured Americans remains questionable at best. Expanding health insurance is not the same as expanding health care, federal programs rarely meet their cost projections and the growing U.S. debt is already a crisis.

Furthermore, taxing people if they do nothing but do not have health insurance is as misguided as the idea that “not buying something” equals commerce. Such a tax, though, is constitutional, so the recourse for voters who object to this tax penalty is in the voting booth, not in the courts.

Polls indicate that few Americans strongly support the law, and changes are certain over the coming years. We’ve said all along that starting with smaller, more manageable initiatives would be a better first step. Others favor a national single-payer health system, while some believe that further expanding Medicare is the best way forward.

Thursday’s ruling is mostly important because it does settle constitutional questions raised by an unprecedented law; objections which, it turns out, had merit. It sets boundaries for Congress, it gives at least some short-term answers for parents of adult children and others, and it allows health professionals to continue implementing the law as written.

Most Americans agree the law, and our system of insurance-driven health care, should change. Thursday’s court ruling allows discussion of those questions to proceed.

Daily Telegram of Adrian, Mich.

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